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General NPI Number Information
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NPI Number | 1982813838
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Entity Type | Organization
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Legal Business Name | RANCHO LAS PALMAS CHIROPRACTIC
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 42700 BOB HOPE DR STE 306
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-7162
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Country | US
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Telephone | 760-346-0082
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Fax | 760-341-3071
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Provider Business Mailing Address
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Address Line | 42700 BOB HOPE DR STE 306
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-7162
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Country | US
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Telephone | 760-346-0082
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Fax | 760-341-3071
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Authorized Official
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Title or Position | OWNER
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Name | BARRY I NELSON
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Credential | D.C.
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Telephone | 760-346-0082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 17769
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License Number State | CA
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